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Validation of presepsin measurement for mortality prediction of sepsis: a preliminary study

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Background: Sepsis and septic shock remain the leading causes of death in critically ill patients worldwide. Various biomarkers are available to determine the prognosis and therapeutic effects of sepsis. In this study, we investigated the effectiveness of presepsin as a sepsis biomarker.Methods: Patients admitted to the intensive care unit with major or minor diagnosis of sepsis were categorized into survival and non-survival groups. The white blood cell count and serum C-reactive protein, procalcitonin, and presepsin levels were measured in all patients.Results: The study included 40 patients (survival group, 32; non-survival group, 8; mortality rate, 20%). The maximum serum presepsin levels measured during intensive care unit admission were significantly higher in the non-survival group (4,205.5 pg/ml [1,155.8–10,094.0] vs. 741.5 pg/ml [520.0–1,317.5], P<0.05). No statistically significant intergroup differences were observed in the maximum, minimum, and mean values of the white blood cell count, as well as serum C-reactive protein, and procalcitonin levels. Based on the receiver operating characteristic curve, the area under the curve for presepsin as a predictor of sepsis mortality was 0.764. At a cut-off value of 1,898.5 pg/ml, the sensitivity and specificity of presepsin for prediction of sepsis-induced mortality were 75.0% and 87.5%, respectively.Conclusions: Early diagnosis of sepsis and prediction of sepsis-induced mortality are important for prompt initiation of treatment. Presepsin may serve as an effective biomarker for prediction of sepsis-induced mortality and for evaluation of treatment effectiveness.

Abstract

Background: Sepsis and septic shock remain the leading causes of death in critically ill patients worldwide. Various biomarkers are available to determine the prognosis and therapeutic effects of sepsis. In this study, we investigated the effectiveness of presepsin as a sepsis biomarker.Methods: Patients admitted to the intensive care unit with major or minor diagnosis of sepsis were categorized into survival and non-survival groups. The white blood cell count and serum C-reactive protein, procalcitonin, and presepsin levels were measured in all patients.Results: The study included 40 patients (survival group, 32; non-survival group, 8; mortality rate, 20%). The maximum serum presepsin levels measured during intensive care unit admission were significantly higher in the non-survival group (4,205.5 pg/ml [1,155.8–10,094.0] vs. 741.5 pg/ml [520.0–1,317.5], P<0.05). No statistically significant intergroup differences were observed in the maximum, minimum, and mean values of the white blood cell count, as well as serum C-reactive protein, and procalcitonin levels. Based on the receiver operating characteristic curve, the area under the curve for presepsin as a predictor of sepsis mortality was 0.764. At a cut-off value of 1,898.5 pg/ml, the sensitivity and specificity of presepsin for prediction of sepsis-induced mortality were 75.0% and 87.5%, respectively.Conclusions: Early diagnosis of sepsis and prediction of sepsis-induced mortality are important for prompt initiation of treatment. Presepsin may serve as an effective biomarker for prediction of sepsis-induced mortality and for evaluation of treatment effectiveness.

참고문헌 (25)

  1. Singer M, "The Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3)", JAMA, 315, pp.801~810 (2016)
  2. Evans L, "Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021", Crit Care Med, 49, pp.e1063~e1143 (2021)[DOI]
  3. Rhee C, "Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014", JAMA, 318, pp.1241~1249 (2017)
  4. Horeczko T, "Epidemiology of the systemic inflammatory response syndrome(SIRS)in the emergency department", West J Emerg Med, 15, pp.329~336 (2014)
  5. Jekarl DW, "Procalcitonin as a prognostic marker for sepsis based on SEPSIS-3", J Clin Lab Anal, 33, pp.e22996~ (2019)
  6. Masson S, "Presepsin(soluble CD14 subtype)and procalcitonin levels for mortality prediction in sepsis : data from the Albumin Italian Outcome Sepsis trial", Crit Care, 18, pp.R6~ (2014)
  7. Jekarl DW, "Procalcitonin as a diagnostic marker and IL-6 as a prognostic marker for sepsis", Diagn Microbiol Infect Dis, 75, pp.342~347 (2013)
  8. Chalupa P, "Evaluation of potential biomarkers for the discrimination of bacterial and viral infections", Infection, 39, pp.411~417 (2011)
  9. Lvovschi V, "Cytokine profiles in sepsis have limited relevance for stratifying patients in the emergency department : a prospective observational study", PLoS One, 6, pp.e28870~ (2011)
  10. Harbarth S, "Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis", Am J Respir Crit Care Med, 164, pp.396~402 (2001)
  11. Yaegashi Y, "Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis", J Infect Chemother, 11, pp.234~238 (2005)
  12. Shozushima T, "Usefulness of presepsin(sCD14-ST)measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome", J Infect Chemother, 17, pp.764~769 (2011)
  13. Vodnik T, "Presepsin(sCD14-ST)in preoperative diagnosis of abdominal sepsis", Clin Chem Lab Med, 51, pp.2053~2062 (2013)
  14. Zou Q, "Presepsin as a novel sepsis biomarker", World J Emerg Med, 5, pp.16~19 (2014)
  15. Wright SD, "CD14, a receptor for complexes of lipopolysaccharide(LPS)and LPS binding protein", Science, 249, pp.1431~1433 (1990)
  16. Vijayan AL, "Procalcitonin : a promising diagnostic marker for sepsis and antibiotic therapy", J Intensive Care, 5, pp.51~ (2017)
  17. Thompson D, "The physiological structure of human C-reactive protein and its complex with phosphocholine", Structure, 7, pp.169~177 (1999)
  18. Liu Y, "Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome : a systematic review and meta-analysis", Springerplus, 5, pp.2091~ (2016)
  19. Levy MM, "The Surviving Sepsis Campaign bundle : 2018 update", Intensive Care Med, 44, pp.925~928 (2018)
  20. Borthwick HA, "Does lactate measurement performed on admission predict clinical outcome on the intensive care unit? A concise systematic review", Ann Clin Biochem, 49(Pt 4), pp.391~394 (2012)
  21. Yamamoto T, "Diagnostic accuracy of presepsin for sepsis by the new Sepsis-3 definitions", Am J Emerg Med, 37, pp.1936~1941 (2019)
  22. Li S, "Serum procalcitonin levels distinguish Gram-negative bacterial sepsis from Gram-positive bacterial and fungal sepsis", J Res Med Sci, 21, pp.39~ (2016)
  23. Lippi G, "Can presepsin be used for screening invasive fungal infections?", Ann Transl Med, 7, pp.87~ (2019)
  24. Becker KL, "Procalcitonin in sepsis and systemic inflammation : a harmful biomarker and a therapeutic target", Br J Pharmacol, 159, pp.253~264 (2010)
  25. Bateman RM, "36th International symposium on intensive care and emergency medicine: Brussels, Belgium. 15-18 March 2016", Crit Care, (20), pp.94~94 (2016)

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